The most played episodes among Podcast App listeners.

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   Number 1: Pain Board Prep: Need to Know Keywords!

   It's the day before the pain boards, so Dr. David Rosenblum skipped the Zoom and recorded a rapid-fire, last-minute review of the high-yield keywords and "board traps" most likely to show up on the ABA Pain Medicine exam. Listen on your commute or at the gym. High-yield topics covered Neonatal pain: A-delta and C fibers and ascending pathways work before birth, but descending inhibition is immature, so neonatal pain may be exaggerated or prolonged. Board trap: incomplete myelination does not mean neonates can't feel pain. Dorsal horn anatomy: Rexed laminae I, II and V. Lamina II is the substantia gelatinosa. Peripheral vs. central sensitization: the "inflammatory soup" (prostaglandins, bradykinin, H+, ATP, histamine, serotonin, cytokines, NGF) causes primary hyperalgesia. NMDA activation, wind-up and expanded receptive fields cause secondary hyperalgesia and allodynia. Superficial cervical plexus (C2–C4): lesser occipital, great auricular, transverse cervical and supraclavicular nerves. Blocked behind the SCM, and useful for clavicle pain. Eagle syndrome: an elongated styloid process irritating the glossopharyngeal nerve. Pain scales: NIPS, CRIES, FLACC and modified FLACC, Wong-Baker FACES, FPS-R, NRS, VAS and PROMIS-10 Global Health. Statistics: sensitivity and specificity don't depend on prevalence, but PPV and NPV do. Type I error is a false positive (α = 0.05) and Type II error is a false negative. Acetaminophen toxicity: use the Rumack-Matthew nomogram at 4 hours or later (acute single ingestion only). N-acetylcysteine is the antidote. Buprenorphine: a high-affinity partial mu agonist and kappa antagonist, with a ceiling effect on respiratory depression. Drug toxicities: carbamazepine (SIADH, SJS with HLA-B*1502, CYP3A4 induction), methotrexate (leucovorin rescue), hydroxychloroquine (retina), TNF-α inhibitors (TB reactivation), JAK inhibitors (boxed warning for MACE, thrombosis, malignancy), NSAIDs, SSRIs/SNRIs and tramadol (hyponatremia). Muscle relaxants: baclofen, tizanidine, cyclobenzaprine, methocarbamol, metaxalone, carisoprodol (meprobamate), chlorzoxazone, dantrolene, diazepam and botulinum toxin (cleaves SNARE proteins). Upcoming events Coming up: the NY/NJ Pain Congress in November and the Latin American Pain Society meeting next year. Hands-on NRAP ultrasound courses in New York are coming up in October and November. See the calendar at nrappain.org. Taking the boards next year? Start here: More CME, board review and ultrasound training at www.NRAPpain.org. Patients: in pain in Brooklyn or NYC? Dr. Rosenblum treats patients with back, neck, joint and nerve pain in Brooklyn, NY, and offers virtual second opinions. Visit RosenblumPain.com or call (718) 436-7246 to book an appointment. For educational purposes only. Not medical advice.

   September 25, 2026·16min
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   Number 2: AI in Pain Medicine: What Every Physician Needs to Know

   Artificial intelligence is moving fast from buzzword to clinical tool — and pain medicine is no exception. In this episode, Dr. David Rosenblum breaks down how AI is already touching the field, drawing on "Artificial Intelligence and Pain Medicine: An Introduction" by Hagedorn, George, Aiyer, Schmidt, Halamka, and D'Souza (Journal of Pain Research, 2024;17:509–518). Topics covered: Why AI is expected to be a genuine turning point for healthcare, not just another tech trend Using machine learning to optimize clinical trial design and patient selection in pain research Natural language processing (NLP) tools that streamline physician workflow and improve doctor-patient communication Deep learning approaches to analyzing patient outcomes and predicting who responds best to a given treatment What better disease recognition and treatment selection could look like in day-to-day pain practice Practical implications for cost and time savings, product development, and clinical decision-making Where the evidence is still early, and what physicians should watch for as AI tools move toward the bedside Bottom line: AI won't replace clinical judgment in pain medicine, but it's already starting to augment it — from trial design to the exam room. Physicians who understand where the technology is headed will be best positioned to use it well. Reference: Hagedorn JM, George TK, Aiyer R, Schmidt K, Halamka J, D'Souza RS. Artificial Intelligence and Pain Medicine: An Introduction. J Pain Res. 2024;17:509–518. https://pmc.ncbi.nlm.nih.gov/articles/PMC10848920/ About the Host David Rosenblum, MD is Director of Pain Management at Maimonides Medical Center and Co-Owner/Clinic Director of AABP Integrative Pain Care and Wellness in Brooklyn, NY. Dual board-certified in Anesthesiology and Pain Medicine, he is a co-author of the ASIPP Peripheral Nerve Stimulation (PNS) guidelines and a widely recognized educator in regenerative pain medicine (PRP, BMAC, amniotic therapies). As founder of NRAP Academy, he has trained 3,500+ physicians for pain board certification since 2008, and hosts the PainExam, AnesthesiaExam, and PMRExam podcasts. He has been named a New York Magazine "Top Doctor" from 2016–2026. Living with chronic pain? Dr. Rosenblum sees patients for interventional and regenerative pain treatment - including epidurals, nerve blocks, spinal cord & peripheral nerve stimulation, and PRP/BMAC - at his Brooklyn, NY office. Visit RosenblumPain.com for more information. or call 718 436 7246 For Physicians & APPs - Continue Your Education: CME Course Calendar: https://www.nrappain.org/pages/upcoming-pain-management-conferences Virtual Pain Fellowship: https://www.nrappain.org/bundles/Virtual-Pain-Fellowship PainExam Board Prep: https://www.nrappain.org/pages/pain-management-cme-courses This episode is brought to you by NRAP Academy and PainExam - visit www.NRAPpain.org for CME in neuromodulation, regional anesthesia, and pain medicine.

   September 14, 2026·24min
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   Number 3: NAD+ Supplementation in Pain and Inflammation: Hype, Hope, or Emerging Science?

   PainExam Podcast Show Notes NAD+ Supplementation in Pain and Inflammation: Hype, Hope, or Emerging Science? Hosted by: PainExam Podcast Presented by: NRAP Academy (Neuromodulation, Regional Anesthesia & Pain) Host: David Rosenblum, MD Episode Overview In this episode of the PainExam Podcast, we explore the growing interest in NAD+ (Nicotinamide Adenine Dinucleotide) supplementation and its potential role in pain management, inflammation reduction, cellular recovery, and healthy aging. NAD+ is a naturally occurring coenzyme found in every living cell and is essential for energy production, mitochondrial function, DNA repair, and cellular resilience. As NAD+ levels decline with age, chronic stress, inflammation, and disease, researchers have begun investigating whether restoring NAD+ levels may improve outcomes in chronic pain conditions and inflammatory disorders. We review the current science, discuss potential mechanisms of action, and examine how NAD+ therapy is being integrated into regenerative medicine, wellness programs, and pain management practices. What is NAD+? NAD+ is a coenzyme involved in: ✅ Cellular energy production (ATP generation) ✅ Mitochondrial health ✅ DNA repair pathways ✅ Oxidative stress reduction ✅ Neuroprotection ✅ Cellular signaling ✅ Activation of longevity-associated proteins called sirtuins Without adequate NAD+, cells become less efficient at producing energy and managing inflammation. Why Might NAD+ Matter in Chronic Pain? Many chronic pain conditions involve: Mitochondrial dysfunction Oxidative stress Neuroinflammation Peripheral and central sensitization Impaired cellular recovery Researchers hypothesize that optimizing NAD+ levels may help address several of these pathways simultaneously. Potential areas of interest include: Neuropathic Pain NAD+ may support: Nerve repair Axonal recovery Mitochondrial function within neurons Reduction of oxidative injury Inflammatory Pain NAD+ influences inflammatory signaling pathways and may help modulate: Cytokine production Immune cell activity Cellular stress responses Fatigue and Recovery Patients with chronic pain frequently report: Fatigue Brain fog Reduced exercise tolerance Poor recovery Because NAD+ plays a critical role in energy metabolism, some clinicians report improvements in energy and recovery following supplementation. Potential Mechanisms of Action 1. Improved Mitochondrial Function Mitochondria generate ATP, the body's energy currency. Reduced NAD+ levels are associated with: Cellular aging Impaired energy production Increased inflammation Supplementation may help restore mitochondrial efficiency. 2. Activation of Sirtuins Sirtuins are proteins involved in: Cellular repair Longevity Metabolic regulation Inflammation control NAD+ serves as a critical substrate for sirtuin activity. 3. DNA Repair Support NAD+ is required for enzymes known as PARPs (Poly ADP Ribose Polymerases), which participate in DNA repair processes following cellular injury. 4. Reduction of Oxidative Stress Chronic inflammation often produces excessive reactive oxygen species (ROS). NAD+ may help maintain cellular antioxidant defenses and reduce oxidative injury. Routes of NAD+ Supplementation Intravenous (IV) NAD+ Most commonly marketed in wellness and recovery clinics. Potential advantages: Direct systemic delivery Avoids gastrointestinal absorption issues Allows higher dosing protocols Potential limitations: Cost Time commitment Variable evidence base Oral Precursors Rather than NAD+ itself, many supplements provide precursors such as: Nicotinamide Riboside (NR) Nicotinamide Mononucleotide (NMN) These compounds are converted into NAD+ within the body. What Does the Evidence Show? Current evidence remains preliminary. While preclinical and mechanistic studies are promising, large-scale randomized controlled trials evaluating NAD+ specifically for chronic pain are still limited. Areas under active investigation include: Neuropathic pain Neurodegenerative disorders Chronic fatigue syndromes Recovery optimization Healthy aging Patients should understand that NAD+ therapy remains an emerging treatment rather than a standard evidence-based pain intervention. Safety Considerations Reported side effects may include: Nausea Flushing Chest tightness during rapid infusions Headache Fatigue Lightheadedness Most adverse effects appear infusion-rate dependent and can often be minimized through slower administration protocols. Patients should discuss treatment with a qualified healthcare professional, especially if they have: Cardiovascular disease Active cancer Significant medical comorbidities Clinical Pearls for Pain Physicians ✔ Consider NAD+ as a potential adjunct—not a replacement—for evidence-based pain care. ✔ Continue emphasizing exercise, sleep optimization, nutrition, behavioral health, and appropriate interventional therapies. ✔ Discuss realistic expectations with patients. ✔ Recognize that evidence continues to evolve. ✔ Focus on patient-centered outcomes rather than laboratory markers alone. Key Takeaways NAD+ is essential for cellular energy production and repair. Declining NAD+ levels may contribute to aging, inflammation, and chronic disease. Early evidence suggests possible benefits in inflammation, recovery, fatigue, and nerve health. Robust pain-specific clinical trials remain limited. NAD+ therapy should currently be viewed as an adjunctive and investigational strategy in pain management. Resources for Physicians Pain Medicine Board Preparation Prepare for the ABA Pain Medicine Boards with: 🎯 Comprehensive Question Banks 🎯 Virtual Pain Fellowship 🎯 Flashcards and Mock Exams 🎯 Weekly Board Review Content 👉 Pain Management Board Prep at NRAP Academy Hands-On Ultrasound Courses – New York Learn: Peripheral nerve imaging Ultrasound-guided injections Regenerative medicine procedures Diagnostic musculoskeletal ultrasound Advanced pain intervention techniques 👉 NRAP Ultrasound Courses in New York Ultrasound & Regenerative Medicine Training – Costa Rica Join physicians from around the world for immersive training in: 🌴 Playa Grande, Costa Rica ☀️ Small-group hands-on instruction 🦴 Regenerative medicine applications 📡 Ultrasound-guided pain procedures 👉 Costa Rica Ultrasound Training Courses Connect With PainExam 🌐 NRAP Academy Website 🎙️ Search PainExam Podcast on your favorite podcast platform. 📚 Explore the Virtual Pain Fellowship, Board Review Programs, Ultrasound Training, and CME opportunities. References Hudson Health. NAD+ Infusion Therapy: Full Clinical Review and Background Paper. 2023. Verdin E. NAD⁺ in aging, metabolism, and neurodegeneration. Science. 2015. Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD⁺ metabolism and its roles in cellular processes. Nature Reviews Molecular Cell Biology. 2021. Rajman L, Chwalek K, Sinclair DA. Therapeutic potential of NAD-boosting molecules. Cell Metabolism. 2018. Katsyuba E, Auwerx J. Modulating NAD⁺ metabolism for health and longevity. Nature Reviews Endocrinology. 2017. Disclaimer: This podcast is intended for educational purposes only and should not be construed as medical advice. Always consult qualified healthcare professionals before initiating any treatment.

   June 24, 2026·15min
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   Number 4: Compression Fractures, Vertebroplasty, Kyphoplasty & Occipital Neuralgia for the Pain Medicine Boards

   PainExam Podcast Show Notes Compression Fractures, Vertebroplasty, Kyphoplasty & Occipital Neuralgia for the ABA Pain Medicine Boards In this episode of the PainExam Podcast, Dr. David Rosenblum reviews two frequently tested topics on the ABA Pain Medicine Board Examination: Occipital Neuralgia and Vertebral Compression Fractures, including the indications, techniques, complications, and evidence surrounding vertebroplasty and kyphoplasty. Whether you are preparing for the ABA Pain Medicine Boards, ABPM, ABIPP, FIPP, or simply looking to strengthen your interventional pain knowledge, this episode covers essential board pearls, anatomy, diagnosis, imaging findings, and treatment options. Episode Highlights Occipital Neuralgia Topics discussed include: Anatomy of the greater, lesser, and third occipital nerves C2 dorsal ramus anatomy and clinical relevance Diagnostic criteria for occipital neuralgia Differentiating occipital neuralgia from: Cervicogenic headache Migraine Cluster headache Tension headache Physical examination findings Occipital nerve blocks Pulsed radiofrequency ablation Cryoneurolysis Peripheral nerve stimulation (PNS) Board Pearl The greater occipital nerve originates from the dorsal ramus of C2 and temporary pain relief following a diagnostic occipital nerve block strongly supports the diagnosis. Vertebral Compression Fractures Topics reviewed include: Osteoporotic vertebral compression fractures Thoracolumbar fracture patterns MRI findings STIR sequence interpretation Patient selection for vertebral augmentation Conservative treatment versus intervention Vertebroplasty technique Kyphoplasty technique Cement leakage and other complications Evidence supporting vertebral augmentation procedures Board Pearl Bone marrow edema on MRI STIR imaging is one of the most important findings suggesting an acute compression fracture. Kyphoplasty vs Vertebroplasty Vertebroplasty Direct injection of PMMA cement into the vertebral body Stabilizes micro-motion within the fracture Can provide rapid pain relief Kyphoplasty Balloon tamp creates a cavity before cement placement May partially restore vertebral body height May reduce risk of cement extravasation Often preferred in selected patients with significant vertebral collapse Commonly Tested Complications Cement leakage Pulmonary cement embolism Adjacent level fractures Infection Neurologic injury (rare) High-Yield ABA Pain Medicine Keywords Occipital Neuralgia Greater Occipital Nerve C2 Dorsal Ramus Third Occipital Nerve Cervicogenic Headache Peripheral Nerve Stimulation Vertebral Compression Fracture Kyphoplasty Vertebroplasty PMMA Cement STIR MRI Osteoporosis Cement Extravasation Upcoming Educational Meetings & Conferences 2026 ASPN Annual Meeting – Miami Learn more about the upcoming meeting hosted by the American Society of Pain and Neuroscience: 📍 ASPN Annual Conference & Miami Meeting Information PainWeek 2026 – Las Vegas Join thousands of pain physicians, APPs, nurses, and industry professionals at: 📍 PAINWeek Las Vegas 2026 Latin American Pain Society Meeting – Brazil For information regarding the upcoming regional pain meeting in Brazil: 📍 Latin American Pain Federation (FEDELAT) Information CME, Ultrasound & Board Review Resources NRAP Academy CME Courses, Virtual Pain Fellowship, Ultrasound Workshops, Regenerative Medicine Training, and Board Review Programs: 📍 NRAP Academy Website CME Calendar Upcoming Ultrasound Workshops, Regenerative Medicine Courses, Board Review Programs, and Conferences: 📍 NRAP Academy CME Calendar Virtual Pain Fellowship Comprehensive longitudinal pain management education: 📍 Virtual Pain Fellowship Program Pain Management Board Review Prepare for: ABA Pain Medicine Boards ABPM ABIPP FIPP 📍 PainExam Board Review Resources Connect With Dr. David Rosenblum Patients Seeking Care Appointments and consultation requests: 📍 AABP Integrative Pain Care & Wellness Physician Education CME, Ultrasound Training, Regenerative Medicine, and Board Review: 📍 NRAP Academy References Margetis K, Patel A, Petrone B, et al. Percutaneous Vertebroplasty and Kyphoplasty. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Updated April 6, 2025. Available at: https://www.ncbi.nlm.nih.gov/books/NBK525963/ Daher M, Kreichati G, Kharrat K, Sebaaly A. Vertebroplasty versus Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures: A Meta-Analysis. World Neurosurgery. 2023;171:65-71. Masala S, Fiori R, Massari F, Simonetti G. Kyphoplasty: Indications, Contraindications and Technique. Radiologia Medica. 2005;110(1-2):97-105. Headache Classification Committee of the International Headache Society (IHS). International Classification of Headache Disorders (ICHD-3). Cephalalgia. 2018. Bogduk N. The Clinical Anatomy of the Cervical Dorsal Rami. Spine-related anatomy and occipital nerve pain syndromes. Subscribe to the PainExam Podcast For weekly board review content, ultrasound-guided procedures, regenerative medicine updates, pain medicine literature reviews, and expert interviews, subscribe to the PainExam Podcast and visit: 📍 PainExam Podcast & Board Review Resources 🎓 Earn CME and advance your skills through the NRAP Academy and Virtual Pain Fellowship.

   May 29, 2026·15min
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   Number 5: CRPS and Intrathecal Pumps- ABA Pain Medicine Board Pearls and more!

   🎙️ PainExam Podcast Show Notes CRPS & Intrathecal Pain Pumps — High-Yield ABA Pain Board Review 🔥 Episode Overview In this episode of the PainExam Podcast, David Rosenblum reviews two essential ABA Pain Medicine Board topics: Complex Regional Pain Syndrome (CRPS) Intrathecal Drug Delivery Systems (Pain Pumps) This episode focuses on: High-yield board pearls Clinical decision-making Interventional treatment strategies Common exam pitfalls Whether you are preparing for the: ABA Pain Medicine Boards ABPM ABIPP FIPP —or looking to sharpen your interventional pain knowledge—this episode delivers practical and testable concepts. 🧠 Topic 1: Complex Regional Pain Syndrome (CRPS) 🔬 What is CRPS? CRPS is a chronic neuropathic pain condition characterized by: Disproportionate pain Autonomic dysfunction Sensory abnormalities Motor and trophic changes 📋 CRPS Types CRPS Type I No confirmed nerve injury Formerly "Reflex Sympathetic Dystrophy" CRPS Type II Confirmed nerve injury Formerly "Causalgia" ⚠️ Pathophysiology CRPS involves: Peripheral sensitization Central sensitization Sympathetic dysfunction Neurogenic inflammation Cortical reorganization 🩺 High-Yield Clinical Features Burning pain Allodynia Hyperalgesia Temperature asymmetry Skin color changes Edema Weakness and trophic changes 📚 Budapest Criteria (BOARD FAVORITE) Diagnosis requires: Continuing pain disproportionate to injury Symptoms in ≥3 categories Signs in ≥2 categories 💊 Treatment First-Line Physical therapy (MOST important) Early mobilization Medications Gabapentin Pregabalin TCAs Interventional Sympathetic blocks Spinal cord stimulation 🚨 Board Pearls Early treatment improves outcomes CRPS may spread beyond the initial site Immobilization worsens symptoms 💉 Topic 2: Intrathecal Drug Delivery Systems (Pain Pumps) 🔬 What Are Intrathecal Pumps? Intrathecal pumps deliver medications directly into the CSF, allowing: Lower systemic doses Better analgesia Reduced systemic side effects 🎯 Indications Failed back surgery syndrome Cancer pain Refractory neuropathic pain Severe chronic pain not responsive to conservative therapy 💊 Common Intrathecal Medications Opioids Morphine Hydromorphone Non-Opioid Ziconotide Other Baclofen (spasticity) ⚠️ Ziconotide — HIGH-YIELD BOARD PEARL Ziconotide: Blocks N-type calcium channels Does NOT cause respiratory depression Can cause psychiatric side effects ⚠️ Major Complications Infection Catheter malfunction Pump failure Withdrawal syndromes Catheter-tip granuloma formation 🚨 Granuloma Formation High-dose intrathecal opioids may cause: Catheter-tip inflammatory masses Cord compression Neurologic deficits 📋 Trialing Patients typically undergo: Bolus trial Continuous infusion trial before permanent implantation. 🎯 Board Pearls Ziconotide = no respiratory depression Pump failure can cause life-threatening withdrawal Granulomas are associated with opioid concentration 📝 High-Yield Board Takeaways CRPS Budapest criteria = critical Early PT = first-line Autonomic dysfunction = hallmark Intrathecal Pumps Ziconotide is highly testable Know granuloma risks Understand pump complications and withdrawal 🎓 Pain Board Prep Resources Prepare for your ABA Pain Medicine boards with: 👉 https://painexam.com 👉 https://nrappain.org 🏆 Why Physicians Choose NRAP Academy Comprehensive board prep High-yield MCQs Virtual Pain Fellowship Ultrasound-guided pain training Interventional pain education 🎤 Upcoming Training Join upcoming: Ultrasound-guided procedure workshops Regenerative medicine courses Pain board review sessions 📢Register today! If you're serious about: ✅ Passing your pain boards ✅ Mastering interventional pain ✅ Improving patient outcomes Subscribe to the PainExam Podcast and join the Virtual Pain Fellowship. 👉 https://nrappain.org 👉 https://painexam.com Reference https://dontforgetthebubbles.com/complex-regional-pain-syndrome/ https://www.ncbi.nlm.nih.gov/books/NBK459151/

   May 12, 2026·13min
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